TREATMENT PLAN

ZANESVILLE — A Kentucky business started by two emergency room physicians in an effort to combat opioid addiction is expected to open its fourth treatment facility in Ohio.

SelfRefind, which uses opioid-based Suboxone to help curb addictive cravings for drugs such as heroin, oxycodone, codeine and hydrocodone, will open a clinic at 2529 Maple Ave., spokesman Keith Tiemeyer said.

Tiemeyer referred other questions to Michele McCarthy, the company’s government liaison, who said no clinic hours have been set but the clinic will begin accepting clients in early October.

McCarthy said that, initially, the clinic will have one physician, Dr. Robert Masone, and three other employees, including an intake coordinator.

SelfRefind will provide the initial physician visit and case management throughout clients’ treatment but will contract with local agencies for program counseling and drug testing services, she said.

Although the clinic will be self-pay to start, McCarthy said, SelfRefind is working to obtain certification as an outpatient treatment facility to enable it to accept Medicaid, Medicare and other health insurance.

Suboxone is used as a maintenance drug to treat opioid dependence, reducing withdrawal symptoms and cravings during treatment.

Patient fees can be up to $350 a month but could drop to $175 as people cycle through their treatment program and remain compliant with random drug tests and medication counts, McCarthy said.

“If they are staying sober and stable, we can lower their medication needs and they can earn eligibility for a decrease in cost,” she said.

McCarthy added that the length of time a client remains on Suboxone is dependent on various factors and could be anywhere from two years or less to five to 10 years.

“What we find with those who have been addicted for so long is it’s going to take some kind of ongoing assistance. It’s really, really hard for these people to know what it’s like to live life sober. Sometimes, it takes years to accomplish.”

McCarthy said the key with the treatment program is making the client realize the problem is often not with the substance but with the negative behaviors that come with it.

“If we can get them to that point where they are changing their behaviors, there’s a better chance that the medication can at least help them cope with those changes,” she said.

Muskingum Behavioral Health Director Steve Carrel has been vocal about the lack of available local services due to funding cuts and has been a driving force behind the Coalition for a Healthy and Drug-Free Muskingum County, which aims to help identify and prevent addiction in the community.

“We don’t have any doctors using Suboxone here in Zanesville, and I think, if counseling is part of the treatment, with continuous monitoring, it can have a positive effect,” Carrel said. “I think we welcome the competition — we were hoping to start our own clinic within the next year — anything that can help us combat the opiate problem.”

Carrel said the Ohio Department of Alcohol and Drug Addiction Services has a Suboxone treatment protocol established to ensure clients are given only enough Suboxone for their treatment so they don’t get addicted to yet another drug. Suboxone contains naloxone and burprenorphine

Physicians who prescribe higher doses than a client can stomach also run the risk of having the client suffer withdrawal from Suboxone when the prescription is reduced, and that also can lead to clients attempting to illicitly sell what they don’t need.

“There’s a nice street value for Suboxone, and there’s the potential there for places that prescribe it to become just another pill mill,” he said.

But Carrel admits he has seen “patients get well with this, and they maintain a longer period of sobriety.”

“If (SelfRefind) do this right, I definitely welcome it,” he said. “It’s not an end-all, cure-all, but Suboxone helps with the cravings, helps people get through the physical and emotional stuff they go through. The key is that there is follow-through, and as long as they do that, Suboxone is a fantastic possibility for treatment.”

Other SelfRefind locations in Ohio include Portsmouth, which opened last fall, Chillicothe in March and Marietta last week. The company also has 12 clinics scattered throughout Kentucky.